Healthcare Provider Details

I. General information

NPI: 1356275887
Provider Name (Legal Business Name): PONTEAH PIROUZAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 PACIFIC AVE
HOOD RIVER OR
97031-1956
US

IV. Provider business mailing address

849 PACIFIC AVE
HOOD RIVER OR
97031-1956
US

V. Phone/Fax

Practice location:
  • Phone: 541-386-6380
  • Fax: 541-386-1078
Mailing address:
  • Phone: 541-386-6380
  • Fax: 541-386-1078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0021055
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: